Projects & Impact

AHP has built its business on applying best practices, many of which we have helped to shape, and real-world, hands-on knowledge to improving systems and business practices for our clients.

In all of the work that we do, we are guided by our mission to improve health and human services systems of care and business operations to help organizations and individuals reach their full potential.

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BHbusiness Plus is funded through a contract with the Substance Abuse and Mental Health Services Administration (SAMHSA). It offers customized, virtual technical assistance and training to behavioral health executives at no cost to participants. The goal is to help behavioral health providers identify and implement customized change projects that expand their service capacity, harness new payer sources, and thrive in the changing health care environment. The program empowers participating organizations to actually make quantifiable changes, rather than just learning how to do so. It links participants into specific learning networks that focus on a specific topic of interest and provides opportunities for networking and peer support. Everyone in a learning network receives hands-on expertise and guidance to initiate, continue, and complete business operations changes.

Participants benefit from the following supports:

focused technical assistance that meets each organization’s business needs;

guidance from a dedicated coach that helps participants develop a customized change project;

access to a peer group of like-minded providers that empowers organizations to learn from combined experiences to grow their businesses;

consultation from leading subject matter experts in the field; and

resources designed to be meaningful to learners, providing practical action steps to meet individual challenges.

Facing evolving state and federal requirements for clinical integration, this group of rural behavioral health providers sought AHP’s help to assess their capabilities and begin to build a provider network to better serve their region. Recognizing the competitive risk of more dominant health systems, these smaller providers have banded together and are collaborating with AHP to strengthen their administrative capacity and efficiency and deliver care more effectively. AHP is conducting a readiness assessment of each provider’s capabilities for forming a provider network model with an analysis of strengths and weaknesses, along with recommendations for the most suitable network model to pursue. In addition, AHP is developing a business planning process with a blueprint for implementation for the chosen model. Each organization will receive a feasibility study and business plan for establishing a shared services organization.

Impact:
Ultimately this work will strengthen all participating community-based behavioral health service agencies involved by creating business operation efficiencies, building a network of shared services, and improving the quality, access, and delivery of behavioral health care to the residents of the rural counties affected.

The Colorado Office of Behavioral Health (OBH) selected a team led by Western Interstate Commission for Higher Education (WICHE) Mental Health Program to conduct a needs analysis and scan of existing and promising behavioral health models. AHP worked with the WICHE team, which included NASMHPD Research Institute (NRI), to complete 17 tasks. AHP assessed:

Olmstead v. L.C. legal decision considerations in the provision of state psychiatric beds;

integration of behavioral health and physical health care;

impact of marijuana legalization and prescription drug misuse on CO OBH service needs;

impact of state drug sentencing reform on CO OBH service needs; and

state approaches to support employment and housing for mental health consumers.

The work on tasks included a literature review, environmental scan, key informant interviews, focus groups, and analysis of existing state-level data. A report was prepared for each task and combined into a comprehensive report that included recommendations for Colorado’s OBH.

This provider association engaged AHP to help form a provider network from among its members. AHP developed a robust strategic business operational plan and pro forma by performing in-depth analyses of key business operations areas and developing an action plan. Building on that work, AHP then facilitated the implementation planning process for credentialing and billing. As a result, AHP delivered a comprehensive roadmap outlining the functional processes to institute and a set of recommendations and procedures to help launch the desired network.

Since 2005, AHP has helped nearly all Massachusetts FQHCs and others in the Northeast and Mid-Atlantic to re-engineer key operational and clinical processes. AHP delivers value to the bottom line through evaluating and improving process mapping and workflow analysis, EHR implementation, identification of barriers and constraints, clinical and operational staff training, and system validation. AHP experts help FQHCs to integrate primary care and behavioral health, conduct strategic planning to meet the requirements of health care reform, and perform protected health information privacy and security assessments. Since 2011, AHP has assisted FQHCs in meeting the Centers for Medicare and Medicaid Meaningful Use.

Impact:
As a result of AHP’s work, many clients have successfully met the Meaningful Use Stage 1 requirements and are in process with Stage 2, receiving hundreds of thousands of dollars in Meaningful Use incentives. AHP’s expertise with FQHCs has led to additional contracts, including Uniform Data Systems for Health Centers.

AHP is collaborating with the Illinois Institute of Technology (IIT) to develop, implement and pilot-test an integrated behavioral health and primary care intervention for homeless African Americans with mental illness. Funded by the National Institute of Minority Health and Health Disparities, in this project, peer navigators—African Americans with lived experience of homelessness and behavioral health problems—connect homeless African Americans with mental illness to medical and mental health care, helping them “navigate” these complicated health systems. AHP and IIT are conducting a randomized controlled clinical trial examining the effectiveness of peer navigators in improving health outcomes for this vulnerable population.

Impact:
Preliminary results suggest that project participants who worked with peer navigators had significant improvements in health functioning. Peer navigators may be a critical tool in helping homeless African Americans with mental illness access the integrated behavioral health and primary care services they need to address their complex health problems.

The Commonwealth of Massachusetts subcontracted AHP to run the federally-funded MA-Access to Recovery (MA-ATR), which is a program designed to give people with substance use disorders wider access to community services that help them recover. Clients choose recovery support services they think will help them most in their recovery by using vouchers they are given to secure these services. MA-ATR’s goal is to enroll over 6,000 individuals within a three-year period.

This project is being implemented in the Greater Springfield and Greater Boston areas where there are high incidences of substance use. AHP’s accomplishments in this contract are summarized below.

Through MA-ATR, AHP created an innovative, nationally acclaimed program called the Career Building Initiative (CBI), designed to address the importance of employment to recovery. Providers were recruited that could provide different kinds of job training and job readiness programs. In addition, in order to eliminate the financial hardships of entering training instead of receiving income from a job, ATR gives every client a work-study benefit of $8 per hour for attendance.

AHP developed a provider network integrating traditional substance use providers with non-traditional recovery support supports and faith-based and community agencies.

Through MA-ATR, AHP created a client-centered system of care by providing clients with choice of services and providers.

AHP customized a curriculum to train eight ATR coordinators on effective engagement techniques, which is a critical skill needed to enroll the target number of clients within the three-year period. ATR coordinators learned follow up techniques such as finding individuals who are experiencing homelessness or are transient.

Impact:
Over a three-year period, the CBI successfully helped many ATR clients become job-ready and get placed into employment. ATR coordinator training contributed to MA-ATR meeting and exceeding the SAMHSA GPRA target follow-up rate (i.e., over 80%), which was maintained into the next round of funding.

Inspira Health Network, an accountable care organization (ACO) with three medical centers and more than 100 access points, sought AHP’s help to make rapid, well-informed decisions about the best allocation of its behavioral health resources and facilities to best serve the surrounding community and deliver value to the bottom line. The goal was to research and deliver a position paper for presentation to legislative, business, and community stakeholders that would encourage support for the ACO’s proposed facility and product expansion. In a very tight timeframe, AHP conducted an assessment of the existing and future business environment, researched and defined the product line and proposed expansion, and developed a paper positioning Inspira Health Network and the benefits proposed for the community.

Impact:
AHP’s final report exceeded the client’s expectations. The ACO leadership was able to provide a highly professional presentation to key stakeholders and advance its business goals for product and facility expansion. Should the plan receive official approval, the health system will build and enhance its behavioral health services delivery.

AHP has contracted with the Substance Abuse and Mental Health Services Administration (SAMHSA) on the Recovery to Practice (RTP) workforce initiative to expand and integrate recovery-oriented care delivered by behavioral health providers across systems and service settings by fostering a better understanding of recovery, recovery-oriented practices, and the roles of the various behavioral health professions in promoting recovery.

The RTP initiative aims to address applications and recovery-oriented practices within multidisciplinary services and integrated settings. The contract tasks include redeveloping and expanding the RTP website, creating quarterly newsletters and other resources; providing technical assistance and educational events to help promote and support recovery-oriented approaches in integrated and multidisciplinary settings; creating new training modules on interdisciplinary service approaches and homelessness; and developing decision support resources for clinicians.

In this project, AHP leads a team that includes the Center for Social Innovation and the Foundation for Mental Hygiene, New York State Psychiatric Institute, Center for Practice Innovation at Columbia University.

Key accomplishments of this project include the development and delivery of 12 onsite and 12 virtual technical assistance programs and presentations for diverse audiences of practitioners, administrators, and consumers; the distribution of four magazine style newsletters with practical information on integrating recovery across a variety of topics and practices to a list of more than 6,000 subscribers; the development of a “virtual grand rounds” six-part clinical decision support webinar series that offers real-world training in recovery-oriented practice to clinicians and prescribers; and the creation of two comprehensive training manuals.

Impact:
RTP materials reach a diverse audience of more than 6,800 professionals via email mailing list, and more than 2,300 individuals registered for the virtual technical assistance events that took place in 2015, representing 49 states and the District of Columbia.

AHP worked with this national association and its affiliate members around the country on a range of projects including re-engineering services and delivery systems in response to the requirements and opportunities under the Affordable Care Act. AHP has worked extensively with the national headquarters of the association to identify opportunities for affiliates, including identifying partnerships with health homes and accountable care organizations, exploring new business opportunities, and expanding publicly funded services into the private pay and third party/managed care markets.

Over several contracts, AHP has conducted studies, provided analysis and technical advice, and reviewed CMHS business operations. In addition, AHP writers are the principal speechwriters for the CMHS Office of the Director. Speeches communicate SAMHSA’s vision, mission, and priorities as they relate to development of a person-centered, recovery-focused, evidence-based, quality-driven system of behavioral health care. Staff members also prepare speeches for meetings of national organizations, SAMHSA grantees, peer-run and recovery organizations, national and international policymaking groups, and congressional committees. In addition, staff members draft posts for SAMHSA’s blog.

AHP’s accomplishments in support of the CMHS Office of the Director are both broad and deep. For example, AHP:

wrote a report to Congress on Borderline Personality Disorder;

helped assess the evidence base for the effectiveness of selected behavioral health treatments;

examined states’ priorities vis-a-vis health reform;

reviewed crisis support programs for people with behavioral health conditions;

examined employment of individuals with behavioral health disorders who have criminal justice involvement;

conducted an examination of patient activation for behavioral health;

developed CMHS program profiles;

helped develop materials related to the prevention of mental, emotional, and behavioral disorders;

examined the relationship of maternal health and child behavioral health outcomes; and

analyzed the extent to which the landmark Supreme Court decision in Olmstead v. L.C. is working for Americans with disabilities, including those with mental and substance use disorders.

In addition, because of AHP’s extensive knowledge and experience in working with SAMHSA over its 20-year history, AHP was tapped to help CMHS developed materials to mark the Agency’s 20th anniversary in 2012.

Impact:
AHP helps SAMHSA articulate its mission, vision, and values to ensure that SAMHSA remains at the forefront of efforts to create person-centered, recovery-focused, evidence-based, quality-driven services for people with mental and substance use conditions.

The Substance Abuse and Mental Health Services Administration (SAMHSA) has contracted with AHP on this national technical assistance and training center, which provides services to Center for Substance Abuse Prevention (CSAP) and Center for Substance Abuse Treatment (CSAT) grantees funded through the SAMHSA Minority AIDS Initiative. Through onsite and innovative virtual technical assistance (TA), the BH-HIVTAC provides high-quality services to foster an understanding of the people it serves and support development of integrated services that are culturally and linguistically appropriate for these priority populations and their communities.The goal of this TA and and training is to:

increase integration of behavioral health prevention and treatment services, including HIV and viral hepatitis, and strengthen linkages to primary health care; and

increase capacity for local behavioral health provider networks to develop and expand their substance use prevention and treatment services, particularly those integrating HIV and viral hepatitis prevention services and linkages to primary health care.

AHP’s partners on this initiative are the Altarum Institute and the Danya Institute.

Among the major accomplishments in this project, AHP hosted a two-day virtual conference for 62 SAMHSA/CSAP grantees. Approximately 150 participants (project directors and staff, evaluators, and SAMHSA staff) attended the conference, which included keynote sessions, plenaries, and three concurrent workshops each day. Additional activities in this initiative have included a variety of highly interactive national webinars, site visits, phone consultations, and small learning networks all designed to strengthen and support grantee effectiveness.

Impact:
With an innovative 100% virtual grantee conference designed by AHP staff, BH-HIVTAC was able to reach approximately 150 participants and organize hold eight highly interactive sessions on topics ranging from using social media to integrating mental health care into HIV/AIDS services.